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42nd Myanmar Health Research Congress Abstracts of the Posters
Abstracts of the Posters
Characteristics of patients with breast cancer from selected cancer units
in Yangon and Mandalay cities
Myo Khin, Le Le Win, Khin May Oo, San Shwe, Win Pa Pa Naing,
Htain Win and Aung Myo Min
Department of Medical Research (Lower Myanmar)
Breast cancer is the most frequently diagnosed cancer and the leading cause of cancer deaths in females in the ASEAN Region, as well as worldwide. As part of the ASEAN CosTs In Oncology (ACTION) Study, (209) patients with breast cancer from selected cancer units in Yangon and Mandalay cities were investigated for biodata, clinical staging and grading and treatment. The age of the subjects ranged from 27 to 88 years, (Mean + SD 49.8 + 9.5). The majority of the subjects were married (63.6%) and had low level of education (27.8%) and 28.2% were graduates. Most of them were housewives (37.8%) and manual workers (29.7%). Pathological staging was done by tumor, regional lymph nodes, metastasis (TNM classification) and (31.6 %) was in stage IIA, (28.7%) was in stage IIB and (14.4%) was in stage IIIB. Histological grading of the subjects revealed that moderately differentiated carcinoma is the most commonest type (61.7%). About 15% has history of breast cancer among the family members. Among the five recommended treatment regimes, the majority of the subjects had to undergo surgical intervention (90%) and chemotherapy (97.6%). The findings of this study would improve the awareness of the breast cancer among women in the community and the information can be used for health education in breast cancer prevention and control. Poster-2
Knowledge, attitude, perception and practice regarding breast cancer
prevention among female school teachers in Yangon Region
Khaymar Mya1, Yin Thet Nu Oo2, Aye Sandar Mon1, Than Soe Lin1,
Soe Moe Myat2, Ko Ko Zaw 2 and Nay Soe Maung 1
1University of Public Health, Yangon, Department of Medical Science
2Department of Medical Research (Lower Myanmar)
A cross–sectional descriptive study was carried out in 2013 among 405 female school teachers in 8 high schools in East Yangon Region to assess the knowledge, attitude, perception and practice on prevention of breast cancer. Pretested self -administered questionnaire was used. Demonstration of breast self- examination practice and HE using poster and pamphlet on breast cancer was given to participants after data collection. Mean age of the teachers was 47 years and mean Abstracts of the Posters
42nd Myanmar Health Research Congress age of menarche was 13 years. About 45% were single. Among the married respondents, mean number of children was 1.85(SD0.84) and most teachers had breast fed. 28% had family history of cancer and 34.2% reported family history of breast cancer. Mostly reported risk factors were breast lump (67%) and family history (63.4%) and hormone drug users (58%), and mostly reported symptoms were breast lump(90%), lumps in arm pit(67%), and change in breast size and shape(58%). Eighty seven percent reported breast self-examination (BSE) as early diagnosis way. The study showed moderate to low knowledge among teachers. Most had positive attitude towards early diagnosis and BSE. Only 39.6% perceived that they have risk of breast cancer. Sixty two percent reported to have performed breast self-examination. Twelve percent had been examined by a doctor. Most common reasons for examining with a doctor were breast lump and concern for cancer. Proper breast self examination should be promoted among school teachers for early detection of breast cancer. Poster-3
Study of plasma malondialdehyde and serum zinc level in normal pregnant
Aung Myo1, Khin Nwe Kyi2, Aye Aye Myat2, Ohnmar3, Than Oo3, Khin Myo Chit3,
Moe Kyaw1 and Tin Maung Hlaing1
1Defence Services Medical Research Centre
3Defence Services Medical Academy
3University of Medicine (2)

This is a cross-sectional comparative study which was carried out at No.1 Defence
Services Obstetrics, Gynaecology and Children's Hospital (300-bedded). Plasma
malondialdehyde and serum zinc levels were determined by using thiobarbituric
Spectrophotometry malondialdehyde and zinc level in normal non-pregnant women (n=20) were (1.10 ± 0.124 µmol/L and 0.134 ± 0.0142 mg/dl), pregnant women with gestational period of 10 to 13 week (n=20) were (1.19 ± 0.077 µmol/L and 0.105± 0.01 mg/dl), pregnant women with gestational period of 24 to 26 week (n=20) were (1.68 ± 0.063 µmol/L and 0.093 ± 0.009 mg/dl) and pregnant women with gestational period of 36 to 38 week (n=19) were (1.86 ± 0.046 µmol/L and 0.074 ± 0.009 mg/dl). Serum zinc level was significantly lower in pregnant groups than non-pregnant group (p<0.05). Plasma malondialdehyde level of normal pregnant women was significantly higher than that of non-pregnant women (p<0.05). There was strong and negative association between malondialdehyde and zinc level of pregnant group with gestational period of 10 to 13 week (n= 20, r= -0.703 and p= 0.001). In other gestational period groups, there was no association between malondialdehyde and zinc level. On conclusion, plasma malondialdehyde level was increased and serum zinc level was decreased along with the gestational period. Malondialdehyde and zinc level were strongly and negatively associated in normal pregnant women with gestational period of 10 to 13 week. It can be suggested that zinc supplement should be started in early gestational period before 13 week. 42nd Myanmar Health Research Congress Abstracts of the Posters
Assessment on effectiveness of safer blood transfusion services in
National Blood Center, Myanmar
Nwe Nwe Oo1, Thaw Zin Aung2, Ikuma Nozaki2, 3 and Thida Aung1
1National Blood Center, Department of Health, Ministry of Health, Myanmar
2JICA Major Infectious Disease Control Project II, Myanmar
3National Center for Global Health and Medicine, Japan
Blood safety is key element of HIV prevention strategy in Myanmar. In order to secure the blood safety, National Blood Center (NBC) introduced several systems including formulation of voluntary donor groups with motivation activities, donor deferral system using questionnaire adapted to Myanmar's situation, and computer based registration system. The objective of the study was evaluating the effectiveness of those interventions. We collected data of blood transfusion service in NBC retrospectively from 2000 to 2012, including number of voluntary and replacement donations and HIV positivity rate in blood screening. We compared the trend of HIV screening positivity rate with estimated adult HIV prevalence by HIV Estimate and Projection Myanmar 2010-2015. During the study period, estimated adult HIV prevalence had increased from 0.65% in 2000 and peaked out in 2003 with 0.73% prevalence, and gradually decreasing to 0.53% in 2012. HIV screening positivity rate among blood donations was 1.0% in 2000 at beginning, but it has been decreasing and became lower than estimated adult prevalence in 2005, just after introduction of 1st generation deferral system using questionnaire. As increasing the percentage of voluntary donations with introduction of other interventions, HIV screening positivity rate continuously decreased to 0.12 % in 2012. The system introduced in NBC was working effectively and contributed for reducing the risk of HIV transmission by blood transfusion services. It should be considered that expansion of the system into other general hospital and specialist hospitals in order to secure the blood safety nationwide. Poster-5
Detection of Clostridium botulinum and toxin production
from some of salted dry fishes
Thin Thin Wah, Lai Lai San, Tin Tin Htwe, May Than Htay, Nilar,
Myo Myo Kyaw, Kyaw Kyaw San and Thaung Hla
Department of Medical Research (Lower Myanmar)
The study of detection of Clostridium botulinum and toxin production from some of salted dry fishes was conducted from May 2012 to April 2013. The study aims to detect Clostridium botulinum and toxin production from some salted dry fishes collected from different kinds of market. Botulism is caused by botulinum toxin Abstracts of the Posters
42nd Myanmar Health Research Congress which is high potent neurotoxin that is formed during the growth of the spore-forming Clostridium botulinum. Among seven types of botulinum toxin, type A, B and E are the most commonly associated with human illnesses. One of the clinical forms of botulism is food-borne botulism which is caused by ingestion of preformed toxin produced in food contaminated with Clostridium botulinum which is gram-positive, spore forming and anaerobic bacilli. Symptoms of botulism may develop between 12 and 72 hours after ingestion of toxin containing food. In this study, total 90 samples (30 samples each of three types of dried form of salted dry fishes such as Heteropneuses fossilis (stinging catfish, nga-gyee), Polydactylus indicus (Indian threadfin, ka-ku-yan) and Lutjanus johnii (john's snapper, Nga-poke) were collected from different sources. Clostridium botulinum was isolated by plating method under anaerobic condition and was found 24 samples (27%) by morphological identification. Mouse bioassay was done to detect production of toxin from the isolated colonies. The toxin production was not detected in this study. The Clostridium contamination in salted dry fishes need to check for toxin production for public food safety. Poster-6
Bio-efficacy and wash resistance of PermaNet® 2.0, PowerNet and K-O-
Tab 123 treated bednets against malaria vector mosquitoes
Maung Maung Mya, Pe Than Htun, Myat Phone Kyaw, Sein Min, Sein Thaung,
Yee Yee Myint, Thu Zar Nyein Mu, Chit Thet Nwe and Yan Naung Maung Maung
Department of Medical Research (Lower Myanmar)
Bio-efficacy and wash resistance of repeatedly hand washed (7 days interval) deltamethrin treated long lasting insecticide nets (LLINs) such as PermaNet®2.0, PowerNet, and K-O-Tab 123+binder net and K-O-Tab only treated net against malaria vectors were evaluated. The study was conducted in the laboratory of Medical Entomology Research Division and in the field at Taikkyi Township from June 2012 to May 2013. Laboratory strain of An.dirus was used to evaluate for susceptibility to selected insecticides used in malaria control. The standard bioassay cone technique following WHO guidelines was used to identify the regeneration time and wash resistance. The LC50 and LC90 values were calculated following Probit analysis. The regeneration study by three days continuous bioassay showed that the efficacy was fully recovered by 24 hours after one and three washes. Wash resistance in terms of 100% knockdown and 100% mortality persisted for 20 washes for wild caught F1 generation of An.dirus from Mudon and also for An.minimus from Laikkyi village but for K-O-Tab only treated net, wash resistance persisted for 15washes against An.minimus. The LC50 and LC90 values of deltamethrin as determined for An.dirus and An.minimus were 0.000008g/l, 0.0000367g/l (χ2=3.3883, p=0.05) and 0.000009g/l, 0.0000372g/l (x2=0.8897, p>0.05) respectively. PermaNet®2.0, PowerNet, and K-O-Tab 123 and K-O-Tab only nets retained good insecticidal efficacy for up to 20 washed cycles producing 86.67-100% mortality against main vectors An. dirus and An. minimus. All tested 42nd Myanmar Health Research Congress Abstracts of the Posters
nets were very effective alternative tools for malaria vector control in support of National Malaria Control Poster-7
Role of serum protein electrophoresis in detection of multiple myeloma
San San Htwe1, Rai Mra2, Htun Lwin Nyein2, Win Pa Pa Naing1, Aung Thu1,
Aye Mya Khine1 and Moe Thuzar Min1
1Department of Medical Research (Lower Myanmar)
2Department of Clinical Haematology, Yangon General Hospital
Multiple myeloma is a neoplasm of B cell lineage characterized by excessive proliferation of abnormal plasma cells, secreting abnormal immunoglobulin causing monoclonal gammopathy which can be detected by the presence of monoclonal (M) protein in serum electrophoresis. The different fractions of the serum proteins separate into 5 bands, as – the albumin, α1, α2, β and the γ globulin fractions by doing electrophoresis. M protein appears as sharp symmetric spike-like peak in the gamma, beta or alpha regions in densitometer tracing. The aim of the study is to detect monoclonal (M) band on serum protein electrophoresis and to quantify monoclonal (M) protein concentration by densitometer. A total of 50 clinically suspected cases of multiple myeloma attended to Department of Clinical Haematology, Yangon General Hospital were selected for the study. Serum protein electrophoresis was performed on cellulose acetate strip. M band was detected visually and estimation of M protein was done by densitometer. Among the 50 cases, 19 cases (38%) had monoclonal gammopathy and were diagnosed to have multiple myeloma. Age of the patients ranged from 52 years to 77 years. The male to female ratio was 1.1:1. All cases had the M band in the gamma (γ) region. The mean concentration of the M protein was 4.63 g/dl, with a range of 3.6 to 7.41 g/dl. Serum protein electrophoresis is an easy to perform laboratory test which can be used for detection and quantification of monoclonal gammopathy and should be recommended as preliminary test for suspected cases of multiple myeloma. Poster-8
Hepatitis B vaccination response in person with Hepatitis C virus
Myat Tin Htwe Kyaw, Aye Aye Lwin, Yi Yi Kyaw, Khin Ohmar Lwin,
Khin May Oo, Win Maw Tun and Kay Khine Soe
Department of Medical Research (Lower Myanmar)
Patients with chronic hepatitis C have been recommended to receive vaccinations against hepatitis B. It is based on the fact that hepatitis C patients co-infected Abstracts of the Posters
42nd Myanmar Health Research Congress with hepatitis B (HB) virus have a higher risk of hepatocellular carcinoma. The aim of the study was to assess the immune response to three doses of plasma-derived HB vaccine in anti-HCV positive persons. A cross-sectional study was conducted among chronic HCV infected persons attending the Hepatitis Carrier Clinic in Department of Medical Research (Lower Myanmar). A total of 75 anti-HCV positive persons were screened. Among them 59 subjects were excluded in whom twenty five subjects were already vaccinated, twenty three were previous anti-HBs positive without HB vaccination, six were cirrhosis of liver detected by USG, three were dual infection and two subjects were anti-HIV antibody positive. Sixteen anti-HCV positive persons were included in the study. Their mean age was 45 ± 12.95 years and male: female was 6:10. Those were vaccinated with three doses of plasma derived HB-DMR vaccine at 0,1, and 2 month schedule by intramuscular route. Antibody to HB surface antigen was measured after completion of second dose and two months after completion of the third dose of vaccination by quantitative ELISA method. Positive anti-HBs antibody with protective level of more than 10 IU/L was only detected in 1/16 (6.25%). The HB vaccine response in patients with hepatitis C infection indicated a diminished response to plasma-derived HB vaccine delivered at a standard dose and schedule compared to its response in persons without HCV infection (98%). Poster-9
Molecular characterization of Chikungunya Virus in Myanmar
Aung Zaw Latt1, Thet Khaing Win2, Saw Win3, Thida Kyaw1,
Kaythi Aye1, Yamin Ko Ko1 and Hlaing Myat Thu1
1Department of Medical Research (Lower Myanmar)
2Ward 17-18, Yangon General Hospital
3Yangon Children Hospital

Chikungunya virus belonging to the Togaviridae family, genus Alpha virus, is
transmitted to human by the bite of Aedes species mosquitoes, leads to an acute
fever associated with an arthromyalgic syndrome. There are three distinct strains:
West Africa, Asia, and East/Central/South Africa. In Myanmar studies on sero-
surveillance were done but there were no genotypic studies on Chikungunya virus.
Acute serum samples collected from YGH and YCH were used for the study. One-
hundred blood samples collected were used for the study. Viral RNA was extracted
and RT-PCR was done. Six out of one-hundred samples were RT-PCR positive. Then
genetic sequencing was done on RT-PCR positive (two) samples, and analyzed for
their genotypes. The resulting genotype was ECSA (East/Central/South Africa)
genotype. There is no vaccine available currently and this study will be the first
genotyping of Myanmar chikungunya virus done in Department of Medical Research
(Lower Myanmar), which is essential to get the base line data especially for
vaccine development.

42nd Myanmar Health Research Congress Abstracts of the Posters
Population structure of the malaria vector Anopheles baimaii in Myanmar
using microsatellite markers
Yan Naung Maung Maung1, Thaung Hlaing2, Sein Min1, Sein Thaung1,
Khin Myo Aye1, Petri Kemppainen3 and Catherine Walton3
1Department of Medical Research (Lower Myanmar)
2Vector Borne Diseases Control, Department of Health
3Faculty of Life Sciences, Manchester University
Microsatellite markers are commonly used to investigate the genetic structuring of natural populations. Understanding gene flow and its effects is important in vector ecology and epidemiology. Anopheles baimaii (formerly An. dirus species D) is the main vector in forested and forest–fringe hilly areas of Myanmar An.baimaii also occurs widely in Southeast Asia and North-Eastern region of India. The genetic population structure and the basic population genetics parameters of An.baimaii in Myanmar were estimated using microsatellite markers. Anopheles baimaii well collected from geo-referenced (11) townships in Myanmar. (123) mosquitoes samples from NE India were added to this study. Six microsatellite markers were used for Multiplex PCR and subsequent sequencing. Alleles scoring was done by Gene Mapper and analysed for population parameters using Genepop, Structure, Arlequin and ‘R' software. The central and southern Myanmar populations were genetically distinct from NE India population but the populations from North-western part of Myanmar were similar to NE India populations, indicating that Arakan mountain range between Myanmar and NE India is a significant barrier to gene flow. Poster-11
Evaluation of antispasmodic activity of Atalantia monophylla
Correa.(awma&Smuf) root on isolated rat intestine
May Aye Than1, San San Myint1 and Khin Mar Naing 2
1Department of Medical Research (Lower Myanmar)
2Botany Department, Yangon University

In order to combat the problems of spasmodic pain due to spasm of muscle including
intestinal smooth muscle locally, most of the people uses lubricants and antispasmodic
of natural products. The aim is to evaluate phytochemical, elemental analysis, acute
toxicity and antispasmodic activity of Atalantia monophylla Correa.(awma&Smuf)
root from Sagaing Division. The phytochemical examination showed the presence of
alkaloids, flavonoids, steroids/terpenoids, saponins, carbohydrate, reducing sugars,
glycosides, tannins, phenolic compounds and amino acids in the roots. The principal
element in root as calcium, potassium and iron were detected. No toxic compound and
metal like cyanogenic glycoside and arsenic detected. No acute toxicity effect even
Abstracts of the Posters
42nd Myanmar Health Research Congress with maximum permissible dose of 12g/kg per orally. In vitro the antispasmodic activity of 95% ethanolic extracts of A. monophylla were carried out by using acetycholine (Ach) -induced contraction in isolated rat intestine. The relaxation effects on smooth muscle of isolated rat intestines were also observed in various concentrations of 95% ethanolic extracts 2,3,4,5, 6mg/mL bc (bath concentration m=7). The mean percent inhibition of height of contraction of extract 2mg/mLbc, 3mg/mLbc, 4mg/mLbc, 5mg/mLbc and 6mg/mLbc were 56.52±6.17, 70.26±5.84, 78.10±5.76, 85.99±5.50 and 85.99±5.50 respectively, It was dose dependent manner with ED50 of 1.52mg/mLbc. The 95% ethanolic extracts 6mg/mLbc of A. monophylla could completely blocked the contraction caused by Ach 0.1mg/mLbc. This Ach concentration was completely blocked by atropine 5mg/mLbc. So the mechanism of action was antimuscurinic activity. Therefore 95% ethanolic of A. monophylla have the relaxation effect on Ach –induced contraction of intestine smooth muscle in dose dependent manner with atropine like activity and potential utility as antispasmodic agent. Poster-12
Clinical significance of admission hematological parameters in patients
with acute myocardial infarct
Zin Zin Thu1, Tin Latt2, Aye Aye Wynn3, Myo Myo Mon1, Kyu Kyu Than1,
Win Pa Pa Naing1 and Aye Mya Khine1
1Department of Medical Research (Lower Myanmar)
2Cardiac Medical Ward, Yangon General Hospital
3University of Medicine (1)
Certain changes in platelet and white blood cells (WBC) have been recognized as an independent risk factor for adverse clinical outcomes among survivors of myocardial infarction. This study aims to assess the clinical importance of hematological parameters in patients with acute myocardial infarction upon hospital admission. A total of 96 acute myocardial infarct patients from cardiac medical ward, YGH were recruited and studied over one year. Hematological analyses of patients were completed within 24 hours after admission and complete blood count was done by using blood film and hematology analyzer. Seventy eight patients (81%) were presented with normal hemoglobin level, 3 patients (3%) with high hemoglobin level and 15 patients (16%) with anemia. Normal platelet count was found in 93 patients (97%) and 3 patient (3%) showed low platelet count. Approximately 30% (31 patients) showed normal WBC count (4-11 x 106/µl), 70% (65patients) was found to have leucocytosis. Among the patients with leucocytosis, 61 patients showed WBC count of 11.1– 20 x106/µl and 4 patients in this group expired (6.6 % fatality rate). Another 4 patients were presented with WBC count of 20.1-33.4x 106/µl and 2 of these patients expired (i.e.50 % fatality) during the period of this study. This study showed that marked leucocytosis (> 20.1 x 106/µl) was associated with increased proportion of hospital death in patients with acute myocardial infarction. Significantly, routine admission WBC count in acute myocardial infarct patients may serve as a potential prognosis tool which is relatively simple to perform and easy interpret, widely available and cost effective. 42nd Myanmar Health Research Congress Abstracts of the Posters
Innovative male participation process in achieving maternal and newborn
health outcomes in South Dagon Township, Yangon
Hnin Kalayar Kyaw1, Mya Mya Win2, Nay Win Ko Ko1, May May Khin1,
Aye Aye Myint1, Thwe Thwe Win1, Kyu Kyu Than1 and Myo Myo Mon3
1Burnet Institute Myanmar
2Department of Health
3Department of Medical Research (Lower Myanmar)
Men in Myanmar play an important role in decisions that are critically to Maternal and Newborn Health. An innovative community base intervention study was carried out from May 2011 to June 2012 in South Dagon Township. Two hundred married men whose wives have experienced at least one child birth and husbands of pregnant women were included in the study.The objective of the study was to find out the knowledge, perception and practice of men regarding antenatal care, postnatal care, contraception and newborn care before and after intervention. Innovative processes includes advocacy process involving male participation and idea generation with various stakeholders, training of Basic Health Staff on role of male in Maternal and Newborn Health, behavior change strategies to involve men with local networks: Myanmar Red Cross Society and Myanmar Maternal and Child Welfare Association, health education to men in the community using participatory approaches and mass mobilization activities: design contest for creating male friendly room in existing health facility and creating an enabling environment for male involvement. Main outcome measures have shown higher achievement in most of the parameters: better knowledge and participation in antenatal care practice and birth preparedness with save daily income for new child. The main lesson learnt through this innovative intervention is that male are willing to learn about the Maternal and Newborn Health care activities and creating male friendly space could initiate men for more involvement in the antenatal, postnatal and contraceptive practices. Keywords: MNCH; male participation; AN care; Yangon Poster-14
Assessment of the Quality of HIV testing in Myanmar
Latt Latt Kyaw1, Ikuma Nozaki2,3, Khin Yi Oo1and Namiko Yoshihara2
1National Health Laboratory, Ministry of Health, Yangon, Myanmar
2JICA, Major Infectious Disease Control Project II, Yangon, Myanmar
3National Center for Global Health and Medicine, Tokyo, Japan
Early diagnosis of HIV/AIDS has been widely recognized as effective strategy for facilitating behavioral changes and early access to treatment, while resource-limited settings in laboratories often faced difficulties. National Health Laboratory (NHL) Abstracts of the Posters
42nd Myanmar Health Research Congress organized National External Quality Assessment Scheme (NEQAS) for HIV testing using proficiency panel biannually since 2005.Participated laboratory retest 5 serum panels and report back to NHL. We reviewed NEQAS Reports of panel 1 to 16 to collect the data including number of laboratories under NEQAS, reporting rate, rate of laboratories reporting aberrant test results, rate of false positive or false negative, and assessment of those aberrant results. The number of laboratories participating in NEQAS has been gradually increased from 65 in 2005 to 347 in 2012. Responding rate of laboratories slightly dropped from 100% in 2005 to 91.1% in 2012 as expanding the program into laboratories of remote areas. The rate of laboratories reporting the false result was slightly improved from 9.2% in 2005 to 5.4% in 2012. We observed comparatively high false negative rate (63.1%), since aberrant results were most frequently happened with weak positive samples. Supervisory visit revealed some weakness in HIV testing procedures, such as wrong incubation time, using too much amount of the specimen, probably due to lack of necessary equipment such as timers and micro pipettes. Well functioning NEQAS found that most of the laboratories show good performance despite hard situation, but some still need to improve. Continuous technical support through NEQAS is essential for the quality improvement of HIV testing. Poster-15
Enhancing bed-net delivery mechanisms and early diagnosis and prompt
treatment for malaria among resident and migrant households in
Tanintharyi Coastal Region, Myanmar
Khin Myo Aye1, Myat Phone Kyaw1, Khin Thet Wai1, Myo Min3, Tin Oo1,
Aye Than1, Lu Lu Kyaw Tin Oo2, Chan Myae Hlaing2 and Tin Tin Wai1
1Department of Medical Research (Lower Myanmar)
2Medical Officer, Clinical Research Unit
3 Myanmar Medical Association
Process monitoring is essential to uncover limitations for strengthening malaria interventions. This cross sectional study conducted in March, 2013 in 16 villages of two townships of the selected coastal region covered 210 households of resident villagers and 202 migrant households. During structured interviews, migrants reported night time work and suspected malaria within past 6 months significantly higher than resident villagers (58.9% vs. 31.4% and 111 persons vs. 74 persons). Potential risks contributed towards malaria in migrants may include significantly lower rate of treated bed-net ownership (51.5% vs. 97.1%), receiving health messages (18.8% vs. 48.6%), and less positive attitudes towards sleeping under the treated nets to prevent malaria (76.2% vs. 84.8%). Among total bed nets observed, the proportion of factory treated nets was lower in migrant households than resident villagers (49% vs. 72%). Concomitantly, in both groups the awareness level for facilities/personnel providing early diagnosis and prompt treatment of malaria was not high. Similarly, they had poor knowledge for the requirement of antimalarials only after the confirmation of suspected fever and also for the preference of combined therapy over monotherapy. However, around 67% of migrants and 71% of resident villagers knew to confirm with the rapid diagnostic test prior to 42nd Myanmar Health Research Congress Abstracts of the Posters
antimalarials. Less than 50% in both groups could cite the recurrence of fever and
persistent infection due to non compliance of full course of antimalarials.
Therefore, especially for hard to reach populations, alternative strategies for public-
private partnership involving social entrepreneurs might enhance accessibility,
coverage, and affordability to changing malaria containment scenario.

Assessment of osteoporosis in female breast cancer patients attending
Medical Oncology Ward, Yangon General Hospital
Than Than Aye1, Yae Chan1, Han Win1, Ko Ko Zaw 1 and Khin Thinn Mu2
1Department of Medical Research (Lower Myanmar)
2Medical Oncology Ward, Yangon General Hospital
A cross-sectional descriptive study was carried out in Medical Oncology ward, Yangon General Hospital during 2012 to explore osteoporosis status among female breast cancer patients. A total of 95 histologically proven female breast cancer patients were interviewed using semi-structured questionnaire and medical records were also reviewed. Their osteoporosis status were assessed by measuring bone mineral density(BMD) with Quantitative Heel Ultrasound (Sonost 3000 Bone Densitometer) and measured BMD were classified into Normal(T score > -1.0) , Osteopenia (T score: between -1.0 and -2.5) and Osteoporosis (T score < -2.5 ) by using WHO criteria for Osteoporosis in Women. Their ages ranged from 31 years to 74 years and mean age was 50.5 ± 9.7 years. Their mean body mass index (BMI) was 23.5± 3.6 kg/m2 and only 31% completed high school and above educational levels. Nearly two third of the subjects (63%) were postmenopausal women. At the time of initial diagnosis, 63% presented as advanced disease and majority(93%) was ductal type. All of the respondents have received treatment with either surgery alone (8%) or combined therapy(92%). Regarding clinical manifestation, 62% did not show any symptom of osteoporosis and the commonest symptoms among symptomatic patients were numbness(21%) which may be due to various cause and back pain (17%). Out of 95 studied subjects, 66(70%) was found to have osteoporosis, 26(27%) osteopenia and only 3(3%) normal. Moreover, osteoporosis was observed more commonly in older age group (≥50 years; p = 0.026), postmenopausal group(p = 0.029) and lower educational group(below high school; p = 0.001) Poster-17
Evaluation of the antioxidant activity of two species of Hylocereus
Mie Mie Nwe, Khin Taryar Myint, Aung Myat Kyaw, Win Win Maw,
Phyu Phyu Zin, Nwe Nwe Oo and May Aye Than
Department of Medical Research (Lower Myanmar)
Abstracts of the Posters
42nd Myanmar Health Research Congress Nowadays people want to eat antioxidant food for many purposes. The aim of the
study is to determine the antioxidant activity of peel and pulp of (two) species of
dragon fruits of the cactaceae family, the white dragon fruit Hylocereus undatus
Hylocereus polyrhizus (e*g;armufoD;teD). The white dragon fruits were bought from super market and
the red dragon fruits were bought from the plantation site of Myae Padaythar. The
antioxidant activities of dragon fruit was evaluated by DPPH (1-1 diphenyl -2-
picryhyldrazyl) method. This method is based on the changes in absorbance at
517nm of spectrophotometer. The antioxidant activity or free radical scavenging
activity is usually express in term of percent inhibition and ascorbic acid as
standard antioxidant. These activity were detected in, 95% ethanol extract of peel
and pulp juice in white fruits. In red fruits both peel and pulp were extracted by
50% ethanol. The antioxidant activity of the extracts and juice of two species of
dragon fruits was found in 4µg/ml concentration. The percent inhibition of pulp of
white dragon fruit was 83.5% and peel of the fruit was 77.9%. In red dragon fruit,
the antioxidant activity of pulp was 63.8% and peel was 64.0%. The standard
ascorbic acid showed 98.3%. From these findings high level of antioxidant activity
was detected in pulp of white dragon fruit. This is the preliminary study and needs
to extend on dragon fruits with different species which are cultivated in different
areas of the country.
Comparative study of effectiveness of Albendazole and Mebandazole
in soil-transmitted Helminthiasis of school children
Aye Than1, Khin Maung Lwin2, Khin Thet Wai1, Ni Ni Zaw1, Thin Thin Aye1,
Khin Mya Ei2, Myat Htut Nyunt1, Thaung Hlaing2 and Kay Thwe Han1
1Department of Medical Research (Lower Myanmar)
2Department of Health
Children are mostly at risk of soil-transmitted helminthiasis(STH),which affects their health and development. Therefore, school based helminthiasis control have been discussed and conducted as one way of cost-effective in developing countries, including Myanmar. However, a comparative study to assess the effectiveness of albendazole(400mg) and mebandazole (500mg) in soil-transmitted helminthiasis of school children were done in Kyimyindine Township in 2012. A total of 240 students from 2 primary schools (122 in Albendazole and 118 in Mebandazole) were included in this study. Prevalence of the Ascaris lumbricoides (roundworm) was 178 (74.2%), Trichuris trichiura (whipworm) was 179 (74.6%) and hookworm spp: 11 (4.17%) respectively. In Albendazole group, prevalence of the Ascariasis was reduced from 70.49% to 27.05% while 77.96% to 33.05% in Mebandazole group. Simarility, Trichuris trichiura infection was reduced from 72.95% to 27.86% in Albendazole group and 73.77% to 38.52% in Mebandazole group. The hookworm spp: prevalence rate was reduced from 5.35% to3.57% in albendazole group and 5.65% to 4.2% in mebandazole group. The cure rate (CR) for Ascariasis was 61.62% in Albendozole and 57.60% in Mebandazole group. For 42nd Myanmar Health Research Congress Abstracts of the Posters
Trichuris trichiura infection, CR was 61.81% in Albendazole and 47.78% in Mebandazole group and hookworm spp: infection was 40% in albendazole and 33.46% in Mebandazole group. Thus, comprehensive information to soil-transmitted helminth's drug efficacy is essential in STH control of primary school children. Poster-19
The role of Human Papillomavirus (HPV) in oral leukoplakia, oral
submucous fibrosis and oral squamous cell carcinomas
Moe Thida Htwe¹, Zaw Moe Thein² and Swe Swe Win¹
¹Department of Oral Medicine, University of Dental Medicine, Yangon
²Department of Oral Medicine, University of Dental Medicine, Mandalay
Although tobacco, alcohol abuse and betel quid chewing habit are well recognized risk factors for oral potentially malignant disorders (OPMDs) and oral squamous cell carcinomas (OSCCs), there is evidence to indicate that human papillomavirus (HPV) may also play some inducing role. Human papillomavirus (HPV) infection in OPMDs and OSCCs are controversial. Furthermore, the prevalence of HPV DNA in oral carcinoma varies from study to study. A cross-sectional laboratory based descriptive and analytical study was performed in 62 OPMDs and 62 OSCCs. The presence of HPV infection was detected by Polymerase Chain Reaction (PCR). Buccal mucosa was the most common site for OPMDs [oral leukoplakia (61%) and oral submucous fibrosis (OSMF) (81%)]. In OSCCs, 23% were found in both buccal mucosa and tongue. Mean ± SD for OSCC, OL and OSMF were 59, 50, 33 and they were significantly different (P=0.000). Betel quid chewing habit alone was found to be most common habit in OL, OSMF and OSCCs (38.7%, 54.8% and 54.8%) respectively. HPV was negative in all OPMDs and only three samples (4.8%) of OSCCs were positive and any significant associations were not found between HPV infection and gender, age, site, histological differentiation of OSCCs and grade of epithelial dysplasia for OPMDs. The results suggested that HPV was not play an important role in oral carcinogenesis in this group of Myanmar patients. Poster-20
Involvement in flood-related-health care activities for the flood victims:
who, when and why
Le Le Win1, Yin Thet Nu Oo1, KhinSandarOo1, Kyi Maw Than1, Than Htein Win2,
Thandar Min1, Aye Win Khine1, HlaThidaTun1 and Soe Moe Myat1
1Department of Medical Research (Lower Myanmar)
2Department of Health

A cross-sectional study was conducted to assess communication network regarding
flood-related-health care for the flood victims in Kyaung-kone and Kun-chan-kone
Abstracts of the Posters
42nd Myanmar Health Research Congress Townships during 2013. Face-to-face-interview was done with 200 adult community members and in-depth interview was done with 41 committee members from Township/Village Disaster Preparedness Committees. Interviews were conducted with consent using pretested research tools. Since Kyaung-kone Township was accustomed to flood nearly every year, proper plan for disaster preparation was not prepared and due to bad experience of Nargis, people from Kun-chan-kone Township had well prepared for coming cyclone.In both townships, groups organized by community, village administrators, NGO and INGO helped flood victims for health care. Of which, groups organized by community and village administrators were actively involved in the activities (> 40% each). Most activities were done particularly one month after the flood. Health persons took the main role as they initiated and communicated other people and worked together for the flood victims to get health care in time particularly during flood period.Despite of receiving ample information, a few respondents said they could not follow the instructions, did not understand and/or remember likenames of medicines to keep. Additionally, some barriers slowed down for timely communication like poor transportation, insufficient life-saving routes and shelters were explored. In conclusion, with some limitations, a good communication network was observed in both townships among the committee members, government health workers, local residents and authority person, and international organizations, which resulted in achieving some benefitsfor both community and responsible person. Poster-21
Application of fluorescence microscopy in the diagnosis of tuberculosis
Sann Sanda Khin1, Aung Thu2, Thandar Lwin1, Tun Kyaw Soe1, Khin Zaw Latt1,
Wai Wai Khaing4, Yi Yi Myint4, Erwin Cooreman2 and Htun Naing Oo3
1Department of Health, Nay Pyi Taw
2World Health Organization, Country Office for Myanmar
3Department of Medical Research (Central Myanmar)
4Department of Medical Research (Upper Myanmar)
Most of the world's tuberculosis cases occur in low-income countries, where sputum microscopy with conventional light microscope is primary method for diagnosing pulmonary tuberculosis (PTB). Myanmar is among 22 countries with highest burdens of TB. Fluorescence microscopy is credited with increased sensitivity and lower work effort. Therefore, the application of fluorescence microscopy in screening diagnosis of PTB in Myanmar was assessed. It was a cross-sectional comparative study and total 200 randomly selected X-ray diagnosed TB cases, aged between 13-74 years were included. The yields obtained with Papanicolaou-fluorescence microscopy and Auramine fluorescence microscopy and Ziehl-Neelsen (ZN) conventional method; assessed the efficiency of the Pap-fluorescence microscopy in terms of work load and turn-around-time for diagnosis of tuberculosis were compared. Out of the 200 smears, 115/200 (57.5%) and 46/200 (23%) were positive by auramine and ZN stain respectively, of which 31 (15.5%) samples were positive on both stains. Similarly, 97/200 (48.5%) and 46/200 (23%) were positive by Papanicolaou and ZN stain 42nd Myanmar Health Research Congress Abstracts of the Posters
respectively, of which 29 (14.5%) samples were positive on both stains. The results suggest that both auramine and Papanicolaou fluorescence microscopy were more sensitive than ZN staining in screening diagnosis of pulmonary tuberculosis because of shorter turn-around-time and less work effort. This concludes that it is a better tool for diagnosing pulmonary TB. Further and larger studies are required to recommend Papanicolaou staining for TB in public health program. Poster-22
Drug use pattern, HIV knowledge and accessibility
to harm reduction services in Pekhon Township
Sai Aung Kyaw Myint, Thura Maung Aye, Poe Poe Aung and Khin Hnin Oo
Burnet Institute (Myanmar)
In Myanmar, HIV prevalence is the highest among drug users (21.9%) and the priorities focus on reducing HIV related risk, vulnerability and impact among drug users. To assess drug use pattern, HIV knowledge and accessibility to harm reduction services by the drug users, a cross-sectional survey was conducted using face-to-face interview with 220 drug users in Pekhon Township where harm reduction services are less. Of 217 male and 3 female were interviewed and the mean age was 27 years. Drug users mainly used Yama (84%) and Heroin, Opium, Marijuana, Cough Syrup, Alcohol and Cigarette were also used. Main drug use pattern was inhaling (81.4%) followed by swallowing, smoking, and injecting. About 94% of drug users responded that they did not share needle and syringe during last attempt and 84.1% did not know the availability of new needle and syringes. Although 93.6% of respondents heard about HIV/AIDS, only 23.2% got high knowledge score regarding HIV/AIDS. Mean knowledge score was 6.3 (range 0-11). About 80% of the drug users have never been asking help to stop using drug. About (57.3%) do not know about nearby voluntary counseling and confidential testing (VCCT) service and 90.5% have never been tested HIV before. This study highlight that Yama was major drug which can reduce memory recall and can increase physical violence. The availability and distribution of new needles and syringe is needed to be focused. Low knowledge on HIV highlighted to advance health education on HIV to enhance VCCT services among drug users. Poster-23
Awareness and attitude of public staff towards involvement of General
Practitioners (GPs) in TB control in selected townships, Yangon Region
Khin Sandar Oo1, Saw Saw1, Le Le Win1, Yin Thet Nu Oo1, Tin Mi Mi Khaing2,
Mya Mya Moe3, Thandar Min1, Soe Moe Myat1 and HlaThidaTun1
1Department of Medical Research (Lower Myanmar)
2Yangon Divisional TB Center (NTP)
3Township Department of Health (Thanlyin)
Abstracts of the Posters
42nd Myanmar Health Research Congress With the aim of exploring awareness and attitude of public staff towards involvement of General Practitioners (GPs) in TB control, a cross-sectional descriptive study was carried out in five townships (Kyauktan, Hlaingtharyar, Tharkayta, Dala and Pazundaung) Yangon Region. This study was conducted from January to December 2012.Face-to-face interviews with 160 Basic Health Staff(BHS) and 11indepth interviews with medical officers and TB coordinators were conducted. BHS defined Public Private Mix DOTS (PPM-DOTS) as referring of TB patients (90.6%), disseminating HE (62.5%), treating TB patients (25.6%) and diagnosing TB patients (27.5%). When asking their opinion of magnitude of GPs that would collaborate with Township Health Department (THD),11% thought all GPs would collaborate,24% thought half of GPs would include and 4% said none of the GPs would involve in PPM. More than 98% of BHS stated that role of GPs in PPM-DOTS is important. In-depth interviews with Township Medical Officers and TB coordinators also revealed that most of the BHS understood PPM –DOTS as referral of TB Patients, which is scheme I. Only a few BHS mentioned about scheme II and III. Therefore, most of the BHS had low awareness of PPM DOTS. Findings indicated that advocacy meeting on PPM-DOTS should be done for BHS to enhance their cooperation with GPs in TB control program. Poster-24
Coagulation profile in type-2 diabetes mellitus patients
attending the diabetic clinic, Yangon General Hospital
Myat Mon Oo, Moh Moh Htun, Win Maw Tun, Ohnmar, Yin Min Htun,
Hnin Nu Htwe, Mya Thanda Win and Kay Thwe Win.
Department of Medical Research (Lower Myanmar)
Diabetes mellitus is a chronic disease that causes serious health complications including renal failure, heart disease, stroke and blindness. In Myanmar, the overall prevalence of diabetes mellitus was 11.9% in Yangon Division in 2003. Type 2 diabetes mellitus patients had been known to have a hypercoagulable state and hypofibrinolysis. The coagulation profile, fasting blood sugar (FBS), glycosylated hemoglobin (HbA1c), urea and creatinine levels were determined in 187 type 2 diabetes mellitus patients (44 male, 143 female, mean age 55 ± 11 years) with or without complications attending the diabetic clinic at outpatient department of Yangon General Hospital (YGH). In these patients, prothrombin time (PT) (12.2 ± 1.4sec), activated partial thromboplastin time (APTT) (32.2 ± 4.7sec), thrombin time (TT) (18.1 ± 2.6sec) were within normal ranges. Fibrinogen concentrations (4.2 ± 1.3g/l) compared with normal range (2-4g/l) were increased. Among them, 102 (55%) patients were raised in fibrinogen concentration (5.08 ± 1g/l). Fibrinogen concentration was significantly higher in females (4.4 ± 1.2g/l) than males (4.0 ± 1.3g/l) (p<0.001). In diabetic patients with HbA1c levels more than 6.4%, fibrinogen concentration and TT were significantly increased, 4.4 ± 1.3g/l and 18.9 ± 2.7sec respectively. Of 77 diabetic patients with increased fibrinogen levels measured by using Human PAI-1 ELISA Kit, 49 (64%) had PAI-1 level more than 50ng/ml. PAI-1 level had positive correlation (r=0.3) with increased fibrinogen concentration in type 2 diabetes mellitus patients. The findings on coagulation 42nd Myanmar Health Research Congress Abstracts of the Posters
status and fibrinolytic activity of type 2 diabetes mellitus patients may be beneficial for management of diabetic patients with thrombotic complication. Poster-25
Determination of djenkolic acid concentrations in different preparations
of djenkol beans (Da-Nyin Thee) Archidendron pauciflorum Benth.
Thet Thet Mar, Thaung Hla, Lai Lai San, Thin Thin Wah, Nilar and Myo Myo Kyaw
Department of Medical Research (Lower Myanmar)

Djenkol (jenkol) bean poisoning is a cause of acute renal failure occurring in
tropical countries. The beans are mildly toxic due to the presence of djenkolic acid
which causes djenkolism (jengkol bean poisoning). Djenkolic acid, sulfur containing
non-protein amino acid is a plant toxin of djenkol bean from Archidendron
Benth. This amino acid precipitates as crystals which cause
mechanical irritation of the renal tubules and urinary tract. The aim of the study
was to determine the djenkolic acid concentrations in different preparations of
djenkol bean. This study was laboratory based analytical study. About 250 g (9
seeds) of djenkol beans were prepared; raw, boiled, baked, fried and salted with
water and extracted with 70% ethyl alcohol. The yield amounts of extracts were
22.23g, 19.95g, 20.89g, 23.46g and 17.34g respectively. Each of the extracts was
isolated by using column chromatography and isolated djenkolic acid was
confirmed by thin layer chromatography using standard djenkolic acid. The
concentrations of djenkolic acids were 2.5329g, 0.3993g, 1.6333g, 0.2779g and
0.8446g respectively. Among all preparations raw bean was highest concentration
of djenkolic acid and fried preparation was lowest concentrations. This study
showed that djenkolic acid in fried preparation is significantly lower than raw,
boiled and salted preparation of beans. So the fried preparation is suitable for
people who likes to consume djenkol bean.
Body mass index of medical students in University of Medicine, Mandalay
Sanda Kyaw, Aye Aye Thein, Nwe Nwe Yee, Mar Mar Lwin, Win Yu Aung,
Ei Ei Khin and Khine Cho Myint
Department of Physiology, University of Medicine, Mandalay

The study was carried out to quantify the Body mass index (BMI) among the
medical students in University of Medicine, Mandalay. The changing trend of body
weight was assessed among the students. Second M.B.,B.S students (n=610) were
participated in this study. Height was measured to the nearest 0.1cm using
standard calibrated scale against a wall. Weight was measured to the nearest
0.5kg using bathroom scale weighing machine. BMI was calculated as weight (kg)/
height (m2) and categorized according to BMI criteria for Asian by WHO which sets
Abstracts of the Posters
42nd Myanmar Health Research Congress BMI <18.5 as underweight, 18.5-22.9 as normal, 23.0-29.9 as overweight and ≥30 as obese respectively. Height, body weight, and BMI (mean±SD) for male (n=377; 18.34±0.82 year) and female (n=233; 17.94±0.61year) students were 1.68± 0.06 m, 59.72±11.6 kg, 21.05±3.71 kg/m2, and 1.57±0.05 m, 50.54±9.54 kg, 20.49 ± 3.62 kg/ m2 respectively. Out of 377 male students, 50% was normal weight, 26% was underweight, 22% was overweight, 2% was obese. Out of 233 female students, 56% was normal weight, 29% was underweight, 12% was overweight, 3% was obese. In comparison with previous studies, body weight and BMI of medical students in this study were significantly increased (p<0.001), percentage of students with normal weight was higher and that of underweight students declined obviously. This finding highlights that most of students become aware of controlling normal body weight. Meanwhile, both overweight and underweight students still exist. Therefore, there is a need to keep an eye on lifestyle and dietary habits of young adults for body weight control. Poster-27
Assessment of clinical usage of blood transfusion services
in National Blood Center, Myanmar
Thaw Zin Aung1, Nwe New Oo2, Ikuma Nozaki1, 3 and Thida Aung2
1JICA Major Infectious Disease Control Project II, Myanmar
2National Blood Center, Department of Health, Ministry of Health, Myanmar
3National Center for Global Health and Medicine, Japan
Clinical use of blood product is key element of blood safety program. The objective of the study is evaluating the clinical usage of blood product issued by National Blood Center (NBC), the biggest blood transfusion service in Myanmar as a pilot study. We reviewed the NBC issue register of January 20 to 31 and February 21 and 22, 2013, retrospectively. Recipient ID number, issued blood product, amount, blood type, and diagnosis of recipient were collected from the register. NBC issued 1232 blood products during study period, including 431 (35.0%) whole blood, 313 (25.4%) fresh frozen plasma, 382 (31.0%) packed red cell, and 77 (6.3%) platelet rich plasma. Most common diagnosis for requesting blood was disease of digestive system (298, 24.2%) such as cirrhosis, neoplasms (234, 19.0%) and blood diseases (233.18.9%). Average frequency of blood transfusion was 1.7 times and 38 recipients needed 5 to 10 times during study period. Major reasons for frequent-blood-transfusion were Hemophilia, Leukemia and Cirrhosis due to HBV, HCV and/or alcohol. Most common infectious disease required blood transfusion was anemia due to HIV infection. Blood transfusion for injury, maternal and child diseases are not assessed in this study because those are included in issue registers of other hospitals. More than half of blood products issued by NBC were component in this period. Majority of recipients suffered from chronic illness such as leukemia, hemophilia. Current rapid movement of medical service in Myanmar may increase the needs of blood transfusion by introduction of high standard treatment. 42nd Myanmar Health Research Congress Abstracts of the Posters
A preliminary analysis of oral cancer patients in Asean Costs in Oncology
Study-Myanmar (ACTION Study) 2013
Myomin Thane¹, Le Le Win¹ and Swe Swe Win²
¹ACTION Study Group, Department of Medical Research (Lower Myanmar),
²Department of Oral Medicine and Pathology, University of Dental Medicine

Each year, more than 700,000 new cases of cancer occur in ASEAN countries and oral
cancer ranks fifth most common. In Myanmar, the occurrence of oral cancer is not
clearly known. The purposes of this study are to determine the demographic and
pathologic characteristics, treatments plan, patients' altitude,and causes of death
and to analyze the direct and indirect costs of treatments for oral cancer. In this
study, 36 cases of oral cancer patients who expired within one year after diagnosis
were selected among patients recruited for ACTION Study, admitted at University of
Dental Medicine, Yangon from February 2012 to September 2013. Males were 47% and
females were 53%. Ages over 40 years were highest (97%) and mean age was 62 years.
Squamous cell carcinomas were 89% and tongue was the most common site (42%). As
for tumor staging, stage IV were about 81%. Among the oral cancer patients, 50% were
planned radiotherapy and chemotherapy, 47% for surgery, radiotherapy and
chemotherapy and 3% for surgery and chemotherapy respectively. 56% of patients
didn't receive any treatment. Cancer related deaths were 89% and only 11% were
expired due to other systemic diseases. For total costs, mean costs were 446,447
Myanmar Kyats. Among expired oral cancer patients, squamous cell carcinoma were
the commonest type, where as tongue was the most common site. Over 40 years of
age with advanced stage were found to be high mortality rate. Costs for cancer
medicines and other drugs still expensive and it may burden to low-income families.
In Vitro anti-malarial activity of some Myanmar medicinal plants
Hla Myat Mon1,2,3, Khin Khin Win Aung2, Kay Thi Kyaw2, Gadae Maung Maung2,
Yu Yu Nwe Oo2 and Myat Chaw Su2,3
1Yangon Technological University,
2Myanma Scientific and Technological Research Department, Yangon,
3Mandalay Technological University, Ministry of Science and Technology

Malaria is one of the major public health problems in Myanmar. Resistance to
routine anti-malarial drugs further creates an alarming situation, which requires
intensive search of new, effective, and affordable anti-malarial agents. As part of
our medicinal plant research, we investigated the in vitro anti-malarial activity of
Abstracts of the Posters
42nd Myanmar Health Research Congress some Myanmar medicinal plants using their ethanolic extracts. Drug sensitivity tests were carried out using Plasmodium falciparum, chloroquine sensitive strain FCR-3 by measuring the percent schizont suppression. The concentrations of plant extracts were 100 µg/ml, 50 µg/ml, 25 µg/ml, 12.5 µg/ml, and 6.25 µg/ml in serial dilution. Initial drug sensitivity tests for screening included the first two highest concentrations. Chloroquine diphosphate was included as a positive control. Promising anti-malarial activity was observed in Cyperus rotundus Linn. (Myet-moun-nyin), Curcuma longa Linn. (Na-nwin), Andrographis paniculata Burm.f. (Say-khar-gyi), and Swertia angustigolia Buch.-Ham. (Shan-say-khar-gyi). Percent schizont suppressions of these four plant extracts at 100 µg/ml concentration were 68.85%, 72.13%, 65.57% and 65.57% respectively. They were further tested individually as well as in combination in serial dilution for their in vitro anti-malarial activity and their potential anti-malarial activity was detected. The combination of these four plant extracts in serial dilution of 100 to 6.25 µg/ml concentrations revealed schizont suppression of 95.18%, 67.0%, 37.03%, 30.64% and 26.36% respectively. Present study partly validates the efficacy of Myanmar medicinal plants as candidates to obtain the novel anti-malarial agents of plant origin. Poster-30
Awareness and attitude on Emergency Contraceptive Pills (ECPs)
among drug sellers in Pyin Oo Lwin Township
Tin Tin Wynn1, Theingi Myint2, Hla Soe Tint1, Moe Kyaw Myint1,
Yadanar Aung1, Kyaw Oo1, Khin Lin1 and Kyaw Zin Thant1
1Department of Medical Research (Upper Myanmar)
2Department of Health

A community-based cross-sectional descriptive study was conducted with the
objective of assessing the awareness and attitude on Emergency Contraceptive Pills
(ECPs) among drug sellers in Pyin Oo Lwin Township, from August 2012 to July 2013.
Face-to-face interview with 67 drug sellers, Focus Group Discussion with 30 sellers,
Individual In-depth Interview with 3 sellers and mystery client method with 12 drug
shops were done. The mean age of seller was 27 years, male 56 (83.6%) and 52
(77.6%) were Buddhists. Graduate was 50 (74.6%), owner seller was 29 (43.3%), 36
(53.7%) had less than 3 years selling practice and only 30 (44.8%) had received
training and among them half of sellers had received training more than 2 years ago.
Maximum knowledge composite score was 25 (median=16) and 35 (52.2%) of the
respondents obtained high knowledge level but 49 (73.1%) of respondents obtained
low attitude composite score (0-18, median=9). Among socio-demographic
characteristics education level was significantly associated with knowledge level
(p<0.05). Eighty percent of respondents mentioned they sell ECPs with or without
prescription and 58% of sellers mentioned no limitation in amount of drug. About 29
(43.3%) of sellers responded that they have been advice to consumer for pregnancy
test. Drug sellers' attitude was still limited and malpractice in selling ECP was
found. Hence we need to be strengthening the knowledge and attitude of ECP
among drug sellers who were one of the sources of information about ECP to clients.
42nd Myanmar Health Research Congress Abstracts of the Posters
In future, training programme for drug sellers must be considered in relation with their education level because it was important to increase knowledge level. Poster-31
Community preparedness on hazards from storms and flood
in Kyaung-Kone and Kun-Chan-Kone Townships, Myanmar
Kyi Maw Than, Ko Ko Zaw, Le Le Win, Yin Thet Nu Oo, Khin Sandar Oo,
San San Aye, Kyi Kyi Mar , Pyone Thuzar Nge and Soe Moe Myat
Department of Medical Research (Lower Myanmar), Yangon, Myanmar
A cross-sectional study was done in selected villages of Kyaung-Kone and Kun-Chan-Kone Townships in May and June, 2013. A total of 100 households in each township were studied. Fifty eight percent households in Kyaung-Kone and 41% in Kun-Chan-Kone prepared before natural disasters occur. About 45% and 71% respectively prepared to go to safe place when there was flood. About 60% households in Kyaung-Kone and 59% households in Kun-Chan-Kone had preparations during natural disasters. Some (33.6%) had chosen the safest place within their homes or compounds. Thirty seven percent in Kyaung-Kone and 33 % in Kun-Chan-Kone replied that there are emergency response preparations in their villages when flood occurs. Among them, 19% in Kyaung-Kone and 14% in Kun-Chan-Kone had prepared to send information about disasters. Forty percent in Kyaung-Kone and 14% in Kun-Chan-Kone prepared to do emergency rescue operations. Seven percent in Kyaung-Kone and 14% in Kun-Chan-Kone had learnt disasters prevention training provided by government, non government and other organizations. Nearly 100% in both townships got weather reports from different sources but majority received from radio. The study showed that the community preparations on storms and flood in both townships were slightly low. Thus authorities and policy makers should encourage more for community participation to reduce hazards from natural disasters up to township level in collaboration with local and international organizations. Poster-32
Occurrence of Staphylococcus aureus, Bacillus cereus and their toxins
in foods sold on roadside food stalls
Thaung Hla, Thet Thet Mar, Zin Mi Thein and Wai Lwin Oo
Department of Medical Research (Lower Myanmar)

Food poisoning is one of the acute medical emergencies. These incidents were due
to unhygienic conditions from farm to fork and lack of knowledge regarding food
safety. The objective of this study is to highlight the frequent occurrence of toxin
liberated food poisoning organisms in foods sold on roadside food stalls. A cross-
sectional laboratory based analytical study was carried out in five townships in
Abstracts of the Posters
42nd Myanmar Health Research Congress Yangon Downtown Area. A total of 150 food samples (30 from each township) were collected and tested. The samples were processed and cultured in appropriate media. The growths were identified by colony characteristics, gram staining, some special tests and biochemical reactions. Sensitivity with relevant antibiotic discs was also conducted. Reverse Passive Latex Agglutination tests were performed to detect toxins. Out of 150 samples, 52 (34.66%) were positive for Staphylococcus aureus and Bacillus cereus. Thirty-two were contaminated with Staphylococcus aureus (3 custards, 7 sandwich, 20 sausage and 2 bread and butter varieties). Twenty samples (17 of reheated fried rice and 3 ice-creams) were colonized with Bacillus cereus. Staphylococcus aureus was (100%) resistant to Amoxicillin. Flucloxacillin (90%), Augmentin (95%), Erythromycin(80%), Clindamycin(95%), Methicillin(92%) and Vancomycin(100%) sensitive to this cocci. Bacillus cereus was 100 % resistant to Amoxicillin but was sensitive to Cephalaxin (90%), Augmentin(88%), Erythromycin (75%), Tetracycline (75%), Chloramphenicol (80%) and Septrin (85%). Staphylococcal enterotoxin B was detected in 23 out of 32 and Diarrhoeal type Bacillus cereus enterotoxin in 14 out of 20. Food poisoning due to bacteria is preventable. It is needed to give health education to persons who prepare, sell, handle and consume foods. Poster-33
Promoting use of recommended Artemisinin-based Combination Therapy
(ACT) in preference to Artesunate Mono-Therapy (AMT)
in the private sector, Myanmar
Poe Poe Aung1, Thar Tun Kyaw2, Zaw Linn2, Zaw Win Thein1, Swai Mon Oo1,
Zayar Lynn1, Phyu Thi1 and Ohnmar1
1 Department of Medical Research (Lower Myanmar)
2 Disease Control Programme, Department of Health
In Myanmar, anti-malarial treatment policy in 2008 shifted from monotherapy to artemisinin-based combination therapy (ACT). General practitioners (GP) play an important role in treating malaria patients in rural endemic areas. To assess the use of recommended ACT among GP, a cross-sectional survey was conducted in 2012 in 80 private clinics in townships (Moegok, Sintgu, Pyin-oo-lwin and Madaya) in Mandalay Region. In data collection, 82 GP (62 male, 20 female) were interviewed using semi-structured questionnaire. Additionally, 212 malaria patients' records were reviewed and 54 patients (21 P.falciparum and 33 P.vivax) were interviewed. Mean (sd) duration of GP service was 15.2 (12.2) years and 57.3% had ever attended training on malaria. Regarding diagnosis and treatment, 81.7% of GPs used rapid diagnosis test, 54 (65.8%) used artemisinin (4 monotherapy, 50 combination therapy) for uncomplicated clinically suspected malaria, all used artemisinin (10 monotherapy, 72 combination therapy) for confirmed uncomplicated P.falciparum, and 49 (60%) used chloroquine and primiquine combination for confirmed P.vivax malaria. The availability of standard protocol for uncomplicated malaria and severe malaria were 64(78%) and 42 (51%), respectively. Of 212 records, the cases were 80 P.falciparum, 91 P.vivax, 16 mixed 42nd Myanmar Health Research Congress Abstracts of the Posters
infection and 25 missing results. Of 54 patients, 18 practiced self-medication and seeking treatment at the clinic within 24 hours and 48 hours were 12 (22.2%) and 21(38.9%), respectively. This study highlighted to improve the use of ACT combination drugs for GPs. The distribution in very low cost and encouragement of using the ACT should enhance the promoting use of ACT. Poster-34
Snack consumption pattern of students aged 12-14 years at No. (4) Basic
Education High School, Ahlone Township, Yangon Region
Mya Ohnmar, Theingi Thwin, Moh Moh Hlaing, Sandar Tun,
Maung Maung Myint, Thidar Khine, Lei Lei Myint,
Khin Hnin Wint Phyu and Yin Yin Aye
Department of Medical Research (Lower Myanmar)
The school-based cross sectional descriptive study was conducted during the period from September to November 2012 to find out snack consumption pattern of students aged 12-14 years attending the No (4) Basic Education High School, Ahlone Township, Yangon Region. One hundred and forty students from Grades (8) and (9) participated in this study. Snack consumption pattern of students were assessed using food frequency method. Majority of the students ate pre-packed instant noodle (54.6%), ready-made fried packed snack (55.4%), processed meat (59.2%), candy (45.4%) and Myanmar traditional snacks (60.8%) in 1-3 times per week. Most of the students (50.8%) drank soft drinks 1-3 times per week and (49.2%) of the studied students drank fruit juice 1-3 times per week. More than forty percent (41.5%) and 25.4% of the students did not drink malted drink and milk. The most common snacks they ate were potato chips and candy bars which were significant sources of calories with few nutrients. These snacks are not expensive, of good taste, of attractive packaging material and available at the school canteen and most of the food shops. BMI for age was used to assess nutritional status, 82.3% of students were within normal BMI-for-age, 10 % were underweight, 5.4% were overweight and 2.3% were obesity. Thirty percent of the students were stunted. The findings in this study highlighted the future nutrition intervention efforts should also be focused on increasing the demand for healthy snacks among adolescents.



Journal of Non-Crystalline Solids 331 (2003) 217–227 TEM and XRD study of early crystallization of lithium disilicate glasses P.C. Soares Jr. a, E.D. Zanotto a,*, V.M. Fokin a, H. Jain b a LaMaV – Vitreous Materials Laboratory, Universidade Federal de S ao Carlos, 13595-905 S ao Carlos, SP, Brazil b Department of Materials Science and Engineering, Lehigh University, 18015 Bethlehem, PA, USA


Tropical Medicine and International Health Evaluation of the SPf66 vaccine for malaria control whendelivered through the EPI scheme in Tanzania C. J. Acosta1,2, C. M. Galindo1,2, D. Schellenberg1,2, J. J. Aponte1, E. Kahigwa3, H. Urassa2, J. R. M. ArmstrongSchellenberg2,5, H. Masanja2, R. Hayes6, A. Y. Kitua2,4, F. Lwilla7, H. Mshinda2, C. Menendez1, M. Tanner5 andP. L. Alonso1